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Bladder cancer is a disease in which malignant (cancer) cells form in the tissues of the bladder.The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscular wall that allows it to get larger or smaller to store urine made by the kidneys. There are two kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the blood. They take out waste products and make urine. The urine passes from each kidney through a long tube called a ureter into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body. EnlargeThere are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become malignant (cancerous):
Cancer that is in the lining of the bladder is called superficial bladder cancer. Cancer that has spread through the lining of the bladder and invades the muscle wall of the bladder or has spread to nearby organs and lymph nodes is called invasive bladder cancer. See the following PDQ summaries for more information: Smoking can affect the risk of bladder cancer.Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for bladder cancer. Risk factors for bladder cancer include the following:
Older age is a risk factor for most cancers. The chance of getting cancer increases as you get older. Signs and symptoms of bladder cancer include blood in the urine and pain during urination.These and other signs and symptoms may be caused by bladder cancer or by other conditions. Check with your doctor if you have any of the following:
Tests that examine the urine and bladder are used to diagnose bladder cancer.The following tests and procedures may be used:
Certain factors affect prognosis (chance of recovery) and treatment options.The prognosis depends on the following:
If the cancer is superficial, prognosis also depends on the following:
Treatment options depend on the stage of bladder cancer. Stages of Bladder CancerKey Points
After bladder cancer has been diagnosed, tests are done to find out if cancer cells have spread within the bladder or to other parts of the body.The process used to find out if cancer has spread within the bladder lining and muscle or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:
There are three ways that cancer spreads in the body.Cancer can spread through tissue, the lymph system, and the blood:
Cancer may spread from where it began to other parts of the body.When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if bladder cancer spreads to the bone, the cancer cells in the bone are actually bladder cancer cells. The disease is metastatic bladder cancer, not bone cancer. Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.The following stages are used for bladder cancer:Stage 0 (Noninvasive Papillary Carcinoma and Carcinoma in Situ)EnlargeIn stage 0, abnormal cells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the tumor:
Stage IEnlargeIn stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder. Stage IIEnlargeIn stage II, cancer has spread to the layers of muscle tissue of the bladder. Stage IIIStage III is divided into stages IIIA and IIIB. Stage IVEnlargeStage IV is divided into stages IVA and IVB.
Bladder cancer can recur (come back) after it has been treated.The cancer may come back in the bladder or in other parts of the body. Treatment Option Overview
Key Points
There are different types of treatment for patients with bladder cancer.Different types of treatment are available for patients with bladder cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Five types of standard treatment are used:SurgeryOne of the following types of surgery may be done:
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. ChemotherapyChemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). For bladder cancer, regional chemotherapy may be intravesical (put into the bladder through a tube inserted into the urethra). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Combination chemotherapy is treatment using more than one anticancer drug. See Drugs Approved for Bladder Cancer for more information. ImmunotherapyImmunotherapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This cancer treatment is a type of biologic therapy. There are different types of immunotherapy:
See Drugs Approved for Bladder Cancer for more information. Targeted therapyTargeted therapy is a type of treatment that uses drugs or other substances to identify and attack certain cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. The following targeted therapies are approved for patients with bladder cancer that is locally advanced or has spread to other parts of the body:
Ramucirumab is a type of targeted therapy that is being studied in combination with chemotherapy for the treatment of bladder cancer. It blocks VEGF to help keep new blood vessels from forming. This may keep cancer cells from growing and may kill them. It is a type of angiogenesis inhibitor and a type of monoclonal antibody. New types of treatment are being tested in clinical trials.Information about clinical trials is available from the NCI website. Treatment for bladder cancer may cause side effects.For information about side effects caused by treatment for cancer, see our Side Effects page. Patients may want to think about taking part in a clinical trial.For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment.Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website. Follow-up tests may be needed.Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Bladder cancer often recurs (comes back), even when the cancer is superficial. Surveillance of the urinary tract to check for recurrence is standard after a diagnosis of bladder cancer. Surveillance is closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. During active surveillance, certain exams and tests are done on a regular schedule. Surveillance may include ureteroscopy and imaging tests. See staging tests, above. Treatment of Stage 0 (Noninvasive Papillary Carcinoma and Carcinoma in Situ)Treatment of Stage I Bladder CancerTreatment of Stages II and III Bladder CancerTreatment of Stage IV Bladder CancerTreatment of Recurrent Bladder CancerFor information about the treatments listed below, see the Treatment Option Overview section. Treatment of recurrent bladder cancer depends on previous treatment and where the cancer has recurred. Treatment for recurrent bladder cancer may include the following: Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. To Learn More About Bladder CancerFor more information from the National Cancer Institute about bladder cancer, see the following: For general cancer information and other resources from the National Cancer Institute, see the following: About This PDQ SummaryPhysician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions
have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish. PDQ is a service of the NCI. The NCI is part of the National Institutes
of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH. This PDQ cancer information summary has current information about the treatment of bladder cancer. It is meant to inform and help patients, families, and
caregivers. It does not give formal guidelines or recommendations for making decisions about health care. Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new
information. The date on each summary ("Updated") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about
the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Clinical trials can be found online at
NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237). PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].” The best way to cite this PDQ summary is: PDQ® Adult Treatment Editorial Board. PDQ Bladder Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at:
https://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389479] Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary
and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images. The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page. More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us. What is a neoplasm of the bladder?Bladder neoplasms can arise from any of the bladder layers. They are broadly classified as either epithelial or nonepithelial (mesenchymal), with over 95% being epithelial (,Table 1) (,1). Epithelial tumors with differentiation toward normal urothelium are urothelial.
What is posterior wall of urinary bladder?The bladder is situated just posterior to the pubic symphysis. Posteriorly, the anterior wall of the vagina sits behind the bladder in females. In males, the rectum is located posterior to the bladder.
What is the most common first symptom of a malignant tumor of the bladder?For most people, the first symptom of bladder cancer is blood in the urine, also called hematuria. Sometimes the blood is visible, prompting the patient to visit a doctor.
What is malignant neoplasm of bladder unspecified?You have bladder cancer. The tissue in the body is made up of cells.
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